10-year wait list for surgery, obese woman writes own obit

[oneh2obabe]

When Lillian Coakley told members of her weight loss support group that she was on a waiting list of 10 years for critical weight reduction surgery, they were shocked.

“People are going to die on this list,” they told the 42-year-old Nova Scotia mother of two, who is on a list of more than 2,000 people in the province.

That mid-July day, a frustrated Coakley, who is five-foot-six and weighs 372 pounds, returned home and devised her “*bleep* to” list. She fired off the same email to various government and health officials, criticizing the health-care system for failing those with obesity issues.

In it, she included her own obituary, which noted that her body would be cremated, so that it would not be “carried away to her final resting place by a tractor.”

Someone forwarded her message to obesity specialist Dr. Yoni Freedhoff of Ottawa, who posted part of it on his blog, Weighty Matters. Since then, it’s gone viral and Coakley has become a poster girl of sorts for what’s wrong with funding for bariatric surgery.

Amid the responses in cyberspace — where she has been both lauded for her courage to speak out and lambasted for not trying hard enough to lose weight — came an offer to have the procedure done free in Mexico.

“I’m really overwhelmed,” Coakley told the Star from her home in Sackville, where the single mother lives with her sons, aged 23 and 13.

“I’m nervous about jumping two borders to have surgery, especially when it’s offered in my country. . . . Our government should step up. I don’t really like the thought of going out of my country. That’s the part that scares the daylights out of me.”

But Coakley, who only recently travelled outside her province for the first time, to New Brunswick, notes: “What scares me more is being 600, 700 or 800 pounds and being stuck in my bedroom and having my children have to tend to me.”

Coakley was referred in February by her family doctor for a sleeve gastrectomy. The procedure reduces the stomach by about 80 per cent and suppresses the hormone that causes hunger.

She also suffers from asthma, sleep apnea, high blood pressure and could be susceptible to Type 2 diabetes.

In Nova Scotia, which has the second highest prevalence of obesity and Type 2 diabetes in Canada, the current wait time for weight loss surgery exceeds 10 years. Capital Health, which provides health services in the Halifax region, says it is working to increase its capacity so patients receive treatment sooner.

In Ontario, where recent studies have shown one-fifth of adults are obese, thousands have travelled out of province to undergo bariatric surgery. Wait times have increased since the province brought in a new program to perform such surgeries locally, CBC reported last fall, with some patients waiting as long as two years. A 2010 report in the Canadian Medical Association Journal noted as many as 300,000 Ontarians may be in need of bariatric surgery.

Coakley, who works for a customer care call centre and earns about $24,000 annually, cannot afford treatment at a private clinic, where the procedure costs upwards of $10,000. The prospect of receiving free surgery surfaced when she was contacted by Saskatoon-based Weight No More Consulting, which links clients with international weight loss surgeons.

“The fact that she’s on a wait list of 10 years for a procedure that will, in fact, lengthen her life, cure her co-morbidities and improve her quality of life really doesn’t speak well to the state of health-care funding for obesity treatment programs in Canada,” Freedhoff, a family physician, told the Star.

“As far as obesity treatment goes, bariatric surgery is by far the most well established, robust and reproducible treatment program there is.

“There is very real likelihood that Lillian could develop complications and problems during that 10-year wait, which would either permanently damage her or kill her.”

“If we don’t operate on these people it’s going to cost the system a lot more money,” added Freedhoff, founder of Ottawa’s Bariatric Medical Institute.

He said it’s absurd to blame Coakley for her weight, or to suggest that she simply diet or exercise.

“Medicine isn’t about blame,” he said, adding, “We’ll do liver transplants on people who are former alcoholics . . . We patch people up even if they don’t wear seatbelts.”

For Coakley, surgery could mean the end of a lifelong battle with the bulge, which started when she was 6 months old and given powdered skim milk.

Growing up, she tried every diet to little avail, often gaining more weight. She hasn’t always made healthy eating choices, but has started making better decisions in recent years.

The asthma, along with weak knees, ankles and hips, makes it difficult to be active, she says. She was the mom seated on the park bench watching her son play, rather than interacting with him.

In that fiery email sent three weeks ago, Coakley wrote: “We as taxpayers and humans need to be heard and helped. People need to stop putting a stigma and sweeping weight loss surgery under the carpet and realize people are going to die on this waiting list.”

To date, she says, no one has responded to her concerns.

Lillian Coakley’s self-written obituary

We are sad to inform you of the untimely passing of a young mother, sister, daughter and friend. She died at a young age due to complication with obesity that she fought for years to overcome.

She was the youngest child of 7 and she leaves behind her 2 sons, who both lived at home with her. Her entire life was lived for her boys who she loved immensely and were her pride and joy.

She was survived by her 3 sisters and 3 brothers, along with many nieces and nephews and great nieces and nephews. She loved to sew and do crafts and was an awesome cook and loved to help others and would give what she could to anyone in need. She enjoyed comedy and good laughs.

Lillian suffered many years with asthma, severe high blood pressure, pain due to stress on her joints from her weight and in the last while was diagnosed with sleep apnea and diabetes.

There will be no flowers at her request and the body will be cremated as she would hate to be a burden on her family and have to be carried away to her final resting place by a tractor, so she spared her family with finding a mass amount of pallbearers and more stares and jokes about her weight as her beloved family mourns the loss of her as they did throughout her life.

She would appreciate if you speak out and support Obesity Weight Loss Surgery and obesity awareness and write a letter to your local MLA and to anyone who will listen.

http://www.healthzone.ca/health/newsfea ... n-obituary

[mrj222]

I'm pretty sure she wrote her own obituary when she refused to put down the damn cheeseburger. I have zero sympathy for people who let themselves get that big. At 5 6 and 200 lbs you know you have a problem. Deal with it then not when you reach 400 pounds then cry when our medical system doesn't fit you in right away.

Her eating habbits took longer than 10 years to get her to this point. Take some personal responsibility for your condition and stop blaming the medical system

[Bsuds]

I'm pretty sure she wrote her own obituary when she refused to put down the damn cheeseburger. I have zero sympathy for people who let themselves get that big. At 5 6 and 200 lbs you know you have a problem. Deal with it then not when you reach 400 pounds then cry when our medical system doesn't fit you in right away.

Her eating habbits took longer than 10 years to get her to this point. Take some personal responsibility for your condition and stop blaming the medical system

The same could be said for a smoker who needs a lung! What is not fair is to have to wait that long for any surgery when it can be made available in another country almost immediately. That's whats BS!

[Lady tehMa]

Why not contract out these surgeries down in Mexico? It seems they don't have waitlists . . . and the going rate might be cheaper than up here. Plus with the bariatric surgeries being performed in Mexico, it would free up some operating rooms and surgeons to reduce the current surgery waitlists further - remember the thread "no more waiting for Walid"? Many people are waiting. Seems like a win/win scenario to me.

[Imagination]

I'm pretty sure she wrote her own obituary when she refused to put down the damn cheeseburger. I have zero sympathy for people who let themselves get that big. At 5 6 and 200 lbs you know you have a problem. Deal with it then not when you reach 400 pounds then cry when our medical system doesn't fit you in right away.

Her eating habbits took longer than 10 years to get her to this point. Take some personal responsibility for your condition and stop blaming the medical system

Here's the problem with that thinking. You are assuming the medical community actually knows how to address this, that diets work, that nothing else is at play. That would be naive. There wouldn't be such a major issue if this were the case. In fact most doctors and dietitians are of very little help once the metabolism is wonky and if this woman has been fighting her weight for years you can bet her metabolism isn't reacting normally and it sure won't react to the normal recommendations of calories, low fat, blah, blah, blah. Your assumption that obesity is all due to simply overeating isn't correct. If it's now gone metabolic, heaven help you find someone who can help. If it's psychological, heaven help you to find someone who can help. For just about any reason you can think of for this happening, by the time a person is in the morbidly obese category (and those are the only folks who qualify for the surgery) this is way beyond simply putting down a cheeseburger. It's like telling a person with lung cancer to stop smoking. It's too late for what most would consider normal approaches because there is already a condition present that is going to take more than putting down a cheeseburger to solve. People can yap all they want about why this shouldn't have happened but the thing is, it did happen, and now getting help is out of the question as far as getting help goes and a lot of it has to do with the bigotry and lack of sympathy people like you display. That is not the case with other issues that might come under the same thinking (of being preventable) so why this one?

It's unfortunate she (and many like her) are running into the attitude you are demonstrating when in fact, as stated in the article, the medical community is all too willing to work with others whose conditions are also their personal responsibility. I can't imagine you'd have the same attitude against others who could also be blamed and tell them to stop crying, but with the bigotry and misinformation out there regarding obesity, those who need help are not getting it and are basically shunned by the medical community in general.

Meanwhile consider what is reality here. Many doctors refuse to take on obese patients (more bigotry on their side) so no help there. Many doctors (with attitudes like yours) think it's simpler than it is and prefer to assume their patients are lying and just over eating vs there being something else going on so they dismiss them without any help at all. If losing weight and keeping it off were so simple, it wouldn't be the major industry it is and every magazine on the rack wouldn't have yet another theory of how to lose it. It's a real fight for most of the obese because diets don't work. They know, they've done them all. They have followed what everyone has said with no lasting results.

The medical profession and drug companies make more money by keeping people unhealthy because all those related conditions are worth cash to them, so no incentive to make what might be considered the driving factor go away and try and rebalance the person's metabolism again. Very few doctors are into that at all and what they learn in school would fit a thimble in most cases. Only those who make it their business to study this on their own know what can impact people with these conditions.

All it takes for those who are truly up against it is a simple day surgery which is almost impossible to get in this country under the usual medical system. Most do have to go to Mexico or private clinics which are only in a few cities in this country and pay $10,000+ for the procedure. This is the last ditch treatment which is proving to work very well for those for whom nothing else has worked yet they are refused help.

Meanwhile those who were also 'irresponsible' by not wearing a helmet or driving drunk or any of the other things you can think of that were their own fault are all treated under the health care system without the attitude the morbidly obese face. They get help when certainly most of them are victims of their own stupidity, why not the obese?

[Imagination]

Why not contract out these surgeries down in Mexico? It seems they don't have waitlists . . . and the going rate might be cheaper than up here. Plus with the bariatric surgeries being performed in Mexico, it would free up some operating rooms and surgeons to reduce the current surgery waitlists further - remember the thread "no more waiting for Walid"? Many people are waiting. Seems like a win/win scenario to me.

As I understand it, the problem for people going to other places (even clinics in Canada) for the surgery is their local doctors will not offer follow up. So if they have any issues with the incisions or tubes or simply need an adjustment to their 'fill', they are told to get lost, go back to where the surgery took place. At least one Canadian doctor offers education sessions for other doctors so they can follow up but the takers are few and far between and I am sure they all have very practical reasoning since the surgery is so rare here it might be a waste of their valuable time.

Until this treatment goes mainstream there just is a lot of roadblocks in place.

What is a real shame is this is in/out day surgery usually. So very quick considering the impact it can have and yet it's virtually impossible to have done in most of the provincial health care systems. They don't seem to mind when these folks land in the cardiac unit for weeks on end or needing diabetic supplies or amputations the rest of their lives though. They don't seem to mind the cost of disability payments or special medical equipment when needed by those who can no longer function normally because of wieght, just too expensive and difficult to set up the one thing that might prevent it all.

[whateva]

was reading this. I have to add my 2 cents to this. Why not lower the price on fruits and vegatables and make fast food and junk food more enspensive? It's cheaper to buy donut than to buy a salad. Pop is cheaper than juice.

The govt is to blame. They need to change the system similar to Sweden.